Abstract
SummaryHodgkin's disease is recognized as part of the spectrum of post-transplantation lymphoproliferative disorders (PTLD), although it is still an uncommon de novo malignancy in this population. Epstein–Barr virus (EBV) has been linked to both post-transplant non-Hodgkin's lymphomas and Hodgkin's disease. We report a case of recurrent Hodgkin's disease in a patient who received a renal transplant in childhood and later developed EBV-associated Hodgkin's disease with remission after chemotherapy until subsequent relapse 9 years later that was successfully treated. To our knowledge, this is the first report of recurrent Hodgkin's disease in a transplant recipient. We briefly discuss the pathogenesis of and risk factors for EBV-related PTLD, utility of EBV load surveillance, and the options for treatment of PTLD including immunosuppression reduction, antiviral therapy, anti-CD20 monoclonal antibodies, cytotoxic T cells, and the possible roles of interferon-α and rapamycin.
Highlights
Hodgkin’s disease is recognized as part of the spectrum of post-transplantation lymphoproliferative disorders (PTLD), it is still an uncommon de novo malignancy in this population
Hodgkin’s–Reed–Sternberg (HRS) cells were strongly positive for CD30 and Epstein–Barr virus (EBV)-latent membrane protein (LMP)-1
The patient was changed from Sandimmune to Neoral, and mycophenolate mofetil (MMF) was added
Summary
Washington University School of Medicine, Department of Internal Medicine, Renal Division, St Louis, MO, USA. Keywords Epstein–Barr virus, Hodgkin’s disease, kidney transplant, post-transplant lymphoproliferative disease, recurrence. Received: 28 October 2005 Revision requested: 20 November 2005 Accepted: 30 December 2005 doi:10.1111/j.1432-2277.2006.00273.x
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